Cape Cod Healthcare is reporting an increase in tick activity this year in our region, according to a press release from the organization. But what exactly does that mean?
CAI's Gilda Geist asked Dr. Stephen Rich, professor of microbiology at UMass Amherst, to break it down for us.
Gilda Geist We've been hearing that this summer, Massachusetts has seen higher-than-usual tick activity, and that it's a bad year for ticks. Can you help break down what this means?
Stephen Rich I really don't like the idea of people referring to it as a "bad tick year" because we don't really know what a baseline looks like. We're operating in a world where probably for every person that gets diagnosed with Lyme disease, there's 10 people that have it and don't get diagnosed. Even the CDC [Centers for Disease Control and Prevention] recognizes that. So that means that we'd have to go a long way just in terms of detecting Lyme disease alone before we'd get close to their real number. And so, when people say more people are getting bitten by ticks, I think what they're chewing on is that more people are ending up in emergency rooms and urgent cares with tick bites. Now, does that mean that more people are getting bitten, or there's more people who are made aware? I don't know, and I don't know that I care as much about that question as whether people just know, period, that ticks are out there and they're there every year and it's a persistent problem, and whether it's a little incrementally higher or lower this year is not as important as knowing that they're out there and that there are things that you can do to keep them off you.
GG Why do you think Lyme disease gets more attention than all the other tick-borne illnesses?
SR Ticks aren't very active at this time of year, in August and September. People don't always realize that's some of the lowest activity periods for the black-legged tick, or the deer tick, that transmits Lyme disease. But coming up in October, fully 50 percent of the ticks, half of the ticks, one in two of the ticks that bite you, will be infected with Lyme disease. So, in terms of scope, it's a bigger problem. There are more new cases of Lyme diseases every year than there are HIV/AIDS, for example. So, it's a huge number and all the other tick-borne diseases, which are also important, pale in comparison.
GG This summer there was a high-profile case of Powassan virus on Martha's Vineyard, tragically in an infant. The mother said she had taken the baby out for a 10-minute walk on an island bike path, and that's when the baby got the tick. I think for a lot of people, this story was pretty unsettling. How do you think the general public should balance being safe and smart about ticks with also being able to enjoy a nice day outside?
SR You said it—this is absolutely a tragedy. But I would say that what we've seen, and the work that we do where we test ticks that have bitten people, among the 30-plus individuals that we've seen bitten by ticks that are positive for Powassan virus over the years, none of them ended up with the symptomology that's associated with encephalitis or the kind of symptoms that this tragic case came to. So, it's much like West Nile virus, which is a mosquito-borne disease. We hear all about it all the time. What people don't realize is that many of us get West Nile virus, and it's of no consequence. It doesn't manifest any kind of disease in us. And then there are those instances, like the tragic case with the Powassan, where people get terribly sick, but they're very much the tip of the iceberg, and many more people are getting exposed to Powassan virus than are getting sick from Powassan virus. And again, it's not to take away from those tragic events where you have these grave outcomes, but I think one has to kind of incorporate those real data into assessing what the risk is on a daily basis.
GG Anything else you want to add that you think people should know?
SR There are things that you can do to keep ticks from getting to that point where they're going to transmit. If you wear permethrin-treated clothing, that's one very good way to go about it. So, you spray it on your clothing, or you can buy clothing that has it already impregnated into the fabric. That kills ticks on contact. Or, you can think about wearing a repellent like the ones that you'd use to repel mosquitoes—things containing DEET or picaridin. Or, you could just think about wearing long pants and that kind of thing, which isn't always a great idea in the summer, but it can keep ticks off you.
